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This is VAERS ID 47857

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 47857
VAERS Form:
Age:74.5
Sex:Female
Location:Pennsylvania
Vaccinated:1992-11-05
Onset:1992-11-05
Submitted:1992-12-07
Entered:1992-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLU-IMUNE 1992-1993 EVANS MED & LEDERLE / LEDERLE 335914 / 0 - / IM
PPV: PNEUMOVAX 23 / MSD 0100V / 0 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: STUPOR, MALAISE, CARDIOVASC DIS, INFARCT MYOCARD, HYPERTROPHY

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-05
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: COPD, end stage; hyperlimpidemia; hypertension
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type':

Write-up: pt recvd vax & approx 9 hrs following vax pt devel sweating & did not feel well; pts husband suggested ER but pt did not; pt died @ home;


Changed on 12/8/2009

VAERS ID: 47857 Before After
VAERS Form:
Age:74.5
Sex:Female
Location:Pennsylvania
Vaccinated:1992-11-05
Onset:1992-11-05
Submitted:1992-12-07
Entered:1992-12-14 1992-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLU-IMUNE 1992-1993 EVANS MED & LEDERLE INFLUENZA (SEASONAL) (FLU-IMUNE 92-93) / LEDERLE LEDERLE LABORATORIES 335914 / 0 - / IM
PPV: PNEUMOVAX 23 PNEUMO (PNEUMOVAX) / MSD MERCK & CO. INC. 0100V / 0 - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Cardiovascular disorder, Hyperhidrosis, Hypertrophy, Malaise, Myocardial infarction, Stupor, STUPOR, MALAISE, CARDIOVASC DIS, INFARCT MYOCARD, HYPERTROPHY

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-05
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: COPD, end stage; hyperlimpidemia; hypertension
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': (blank) WAES92111093

Write-up: pt recvd vax & approx 9 hrs following vax pt devel sweating & did not feel well; pts husband suggested ER but pt did not; pt died @ home;


Changed on 8/31/2010

VAERS ID: 47857 Before After
VAERS Form:
Age:74.5
Sex:Female
Location:Pennsylvania
Vaccinated:1992-11-05
Onset:1992-11-05
Submitted:1992-12-07
Entered:1992-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLU-IMUNE 92-93) INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 335914 / 0 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0100V / 0 - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiovascular disorder, Hyperhidrosis, Hypertrophy, Malaise, Myocardial infarction, Stupor

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-05
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: COPD, end stage; hyperlimpidemia; hypertension
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES92111093

Write-up: pt recvd vax & approx 9 hrs following vax pt devel sweating & did not feel well; pts husband suggested ER but pt did not; pt died @ home;


Changed on 7/7/2013

VAERS ID: 47857 Before After
VAERS Form:
Age:74.5
Sex:Female
Location:Pennsylvania
Vaccinated:1992-11-05
Onset:1992-11-05
Submitted:1992-12-07
Entered:1992-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 335914 / 0 - / IM
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 335914 / 0 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0100V / 0 - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiovascular disorder, Hyperhidrosis, Hypertrophy, Malaise, Myocardial infarction, Stupor

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-05
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: COPD, end stage; hyperlimpidemia; hypertension
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES92111093

Write-up: pt recvd vax & approx 9 hrs following vax pt devel sweating & did not feel well; pts husband suggested ER but pt did not; pt died @ home;


Changed on 2/14/2017

VAERS ID: 47857 Before After
VAERS Form:
Age:74.5 74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-11-05
Onset:1992-11-05
Submitted:1992-12-07
Entered:1992-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 335914 / 0 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0100V / 0 - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiovascular disorder, Hyperhidrosis, Hypertrophy, Malaise, Myocardial infarction, Stupor

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-05
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: COPD, end stage; hyperlimpidemia; hypertension
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES92111093

Write-up: pt recvd vax & approx 9 hrs following vax pt devel sweating & did not feel well; pts husband suggested ER but pt did not; pt died @ home;


Changed on 5/14/2017

VAERS ID: 47857 Before After
VAERS Form:
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-11-05
Onset:1992-11-05
Submitted:1992-12-07
Entered:1992-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 335914 / 0 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0100V / 0 - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiovascular disorder, Hyperhidrosis, Hypertrophy, Malaise, Myocardial infarction, Stupor

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-05
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: COPD, end stage; hyperlimpidemia; hypertension
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES92111093

Write-up: pt recvd vax & approx 9 hrs following vax pt devel sweating & did not feel well; pts husband suggested ER but pt did not; pt died @ home;


Changed on 9/14/2017

VAERS ID: 47857 Before After
VAERS Form:(blank) 1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-11-05
Onset:1992-11-05
Submitted:1992-12-07
Entered:1992-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 335914 / 0 1 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0100V / 0 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiovascular disorder, Hyperhidrosis, Hypertrophy, Malaise, Myocardial infarction, Stupor

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-05
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: COPD, end stage; hyperlimpidemia; hypertension
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES92111093

Write-up: pt recvd vax & approx 9 hrs following vax pt devel sweating & did not feel well; pts husband suggested ER but pt did not; pt died @ home;


Changed on 2/14/2018

VAERS ID: 47857 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-11-05
Onset:1992-11-05
Submitted:1992-12-07
Entered:1992-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 335914 / 1 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0100V / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiovascular disorder, Hyperhidrosis, Hypertrophy, Malaise, Myocardial infarction, Stupor

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-05
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: COPD, end stage; hyperlimpidemia; hypertension
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES92111093

Write-up: pt recvd vax & approx 9 hrs following vax pt devel sweating & did not feel well; pts husband suggested ER but pt did not; pt died @ home;


Changed on 6/14/2018

VAERS ID: 47857 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-11-05
Onset:1992-11-05
Submitted:1992-12-07
Entered:1992-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 335914 / 1 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0100V / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiovascular disorder, Hyperhidrosis, Hypertrophy, Malaise, Myocardial infarction, Stupor

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-05
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: COPD, end stage; hyperlimpidemia; hypertension
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES92111093

Write-up: pt recvd vax & approx 9 hrs following vax pt devel sweating & did not feel well; pts husband suggested ER but pt did not; pt died @ home;


Changed on 8/14/2018

VAERS ID: 47857 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-11-05
Onset:1992-11-05
Submitted:1992-12-07
Entered:1992-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 335914 / 1 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0100V / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiovascular disorder, Hyperhidrosis, Hypertrophy, Malaise, Myocardial infarction, Stupor

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-05
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: COPD, end stage; hyperlimpidemia; hypertension
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES92111093

Write-up: pt recvd vax & approx 9 hrs following vax pt devel sweating & did not feel well; pts husband suggested ER but pt did not; pt died @ home;


Changed on 9/14/2018

VAERS ID: 47857 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-11-05
Onset:1992-11-05
Submitted:1992-12-07
Entered:1992-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 335914 / 1 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0100V / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiovascular disorder, Hyperhidrosis, Hypertrophy, Malaise, Myocardial infarction, Stupor

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-05
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: COPD, end stage; hyperlimpidemia; hypertension
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES92111093

Write-up: pt recvd vax & approx 9 hrs following vax pt devel sweating & did not feel well; pts husband suggested ER but pt did not; pt died @ home;


Changed on 10/14/2018

VAERS ID: 47857 Before After
VAERS Form:1
Age:74.0
Sex:Female
Location:Pennsylvania
Vaccinated:1992-11-05
Onset:1992-11-05
Submitted:1992-12-07
Entered:1992-12-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE) / LEDERLE LABORATORIES 335914 / 1 - / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0100V / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiovascular disorder, Hyperhidrosis, Hypertrophy, Malaise, Myocardial infarction, Stupor

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-11-05
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: COPD, end stage; hyperlimpidemia; hypertension
Allergies:
Diagnostic Lab Data: No relevant data;
CDC 'Split Type': WAES92111093

Write-up: pt recvd vax & approx 9 hrs following vax pt devel sweating & did not feel well; pts husband suggested ER but pt did not; pt died @ home;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=47857&WAYBACKHISTORY=ON


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